Can my brother discharge himself or just walk out of a NH?


My brother's name is Jack, he is 70 yrs of age. He was taken to a hospital for emergency care, he admitted & diagnosed with colon cancer. He refused treatment. After almost 3 weeks, the hospital released him to a NH.
Directly before his release, the hospital questioned Jack as to his desire for resuscitative care, he completed the questionnaire & denied all request to extend life. The hospital found Jack to be competent & able to make his own health care decisions. The hospital called me, at Jack's request, to come to the hospital & sign what i believe was a Power Of Attorney before his release. I don't drive & its a lil over an hour away from my house, so I was unable to sign the documents before his release.
2 days after being admitted to the NH, the DX's found him to be unable to make his own health care decisions. The NH Mgmt reached out to me, his sister, and had me come to the NH & sign a Surrogate document. The Mgmt team felt Jack was able to make his own decisions & were going to have Jack re-evaluated. My displeasure for his care was noted. I drove back home. They kept up this charade for 2 wks then Mgmt called at 3pm on a friday to say that my Surrogate document was no longer valid and they would reach out to his immediate family. Another rouse. The NH has no contact info for his estranged wife, children that he has no contact with. I feel the NH is holding on to Jack for the paycheck.
Now the Jack can no longer make his own decisions & I have been removed as his Surrogate, who makes his health care decisions?
Can Jack leave the NH, and if so how?

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Determination of competency has to be done by a physician, not a facility or their administrators.

There are documents that have to be completed. If you want to become your brother's guardian or power of attorney, it seems to me that you are going to need an attorney to explain the processes and be on your side.
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It's a little confusing but my guess is he's become a ward of the state, covered by Medicaid, and a caseworker or case management team will have control of his care. If he is quite ill and mentally incompetent I can't imagine him being released.
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As far as I know, the nursing home can't lock him in. BUT where would he go? Can he come to your home? Does he have his own home? If he doesn't want treatment, he may be a candidate for hospice care . . . but that doesn't eliminate the need for current housing and care.
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